Marie-Aure´lie Bruno,1 Jan L Bernheim,2 Didier Ledoux,1 Fre´de´ric Pellas.

■ Evidence from functional neuroimaging studies on resting state suggests that there are two distinct anticorrelated cortical systems that mediate conscious awareness: an “extrinsic” system that encompasses lateral fronto-parietal areas and has been linked with processes of external input (external awareness), and an “intrinsic” system which encompasses mainly medial brain areas and..

Different sort of people are interested in personal identity. Philosophers frequently ask what it takes to remain oneself. Caregivers imagine their patients’ experience. But both philosophers and caregivers think from the armchair: they can only make assumptions about what it would be like to wake up with massive bodily changes. Patients with a locked-in syndrome suffer a full body paralysis without cognitive impairment. They can tell us what it is like. Forty-four chronic LIS patients and 20 age-matched healthy medical professionals (...) answered a 15-items questionnaire targeting: global evaluation of identity, body representation and experienced meaning in life. In patients, self-reported identity was correlated with B and C. Patients differed with controls in C. These results suggest that the paralyzed body remains a strong component of patients’ experienced identity, that patients can adjust to objectives changes perceived as meaningful and that caregivers fail in predicting patients’ experience. (shrink)

Disorders of consciousness (DOC) raise profound scientific, clinical, ethical, and philosophical issues. Growing knowledge on fundamental principles of brain organization in healthy individuals offers new opportunities for a better understanding of residual brain function in DOCs. We here discuss new perspectives derived from a recently proposed scheme of brain organization underlying consciousness in healthy individuals. In this scheme, thalamo-cortical networks can be divided into two, often antagonistic, global systems: (i) a system of externally oriented, sensory-motor networks (the ‘‘extrinsic’’ system); and (...) (ii) a system of inward-oriented networks (the ‘‘intrinsic’’ or default system). According to this framework, four distinct mental states would be possible that could be relevant for understanding DOCs. In normal healthy volunteers and locked-in syndrome patients, a state of high functionality of both the extrinsic and intrinsic or default systems is expected — associated with full awareness of environment and self. In this case, mental imagery tasks combined with fMRI can be used to detect covert awareness in patients that are unable to communicate. According to the framework, two complementary states of system imbalance are also possible, in which one system is in a hyperfunctional state, while the other is hypoactive. Extrinsic system hyperfunction is expected to lead to a state of total sensory-motor ‘‘absorption’’ or ‘‘lost self.’’ In contrast, intrinsic or default system hyperfunction is expected to lead to a state of complete detachment from the external world. A state where both extrinsic and intrinsic systems are hypofunctional is predicted to lead to markedly impaired consciousness as seen in DOCs. Finally, we review the potential use of ultra-slow fluctuations in BOLD signal as a tool for assessing the functional integrity of extrinsic and intrinsic systems during ‘‘resting state’’ fMRI acquisitions.. (shrink)

Name der Zeitschrift: Jahrbuch für Wissenschaft und Ethik Jahrgang: 19 Heft: 1 Seiten: 147-162.

Personhood is ascribed on others, such that someone who is recognized to be a person is bestowed with certain civil rights and the right to decision making. A rising question is how severely brain-injured patients who regain consciousness can also regain their personhood. The case of patients with locked-in syndrome is illustrative in this matter. Upon restoration of consciousness, patients with LIS find themselves in a state of profound demolition of their bodily functions. From the third-person perspective, it can be (...) expected that LIS patients might experience a differential personal identity and may lose their status as persons. However, from the patients’ perspective, it is uncontested that they retain their personal identity and that they consider themselves to be persons. We here include results from a survey with patients with LIS aimed at identifying the primary expectations of patients for their care by non-medical professionals. Based on these first-hand reports, we argue that personhood in LIS is progressively regained as the widening circle of others recognizes them as persons. (shrink)

A target question for the scientific study of consciousness is how dimensions of consciousness, such as the ability to feel pain and pleasure or reflect on one’s own experience, vary in different states and animal species. Considering the tight link between consciousness and moral status, answers to these questions have implications for law and ethics. Here we point out that given this link, the scientific community studying consciousness may face implicit pressure to carry out certain research programs or interpret results (...) in ways that justify current norms rather than challenge them. We show that because consciousness largely determines moral status, the use of nonhuman animals in the scientific study of consciousness introduces a direct conflict between scientific relevance and ethics—the more scientifically valuable an animal model is for studying consciousness, the more difficult it becomes to ethically justify compromises to its well-being for consciousness research. Finally, in light of these considerations, we call for a discussion of the immediate ethical corollaries of the body of knowledge that has accumulated and for a more explicit consideration of the role of ideology and ethics in the scientific study of consciousness. (shrink)

Personhood is ascribed on others, such that someone who is recognized to be a person is bestowed with certain civil rights and the right to decision making. A rising question is how severely brain-injured patients who regain consciousness can also regain their personhood. The case of patients with locked-in syndrome is illustrative in this matter. Upon restoration of consciousness, patients with LIS find themselves in a state of profound demolition of their bodily functions. From the third-person perspective, it can be (...) expected that LIS patients might experience a differential personal identity and may lose their status as persons. However, from the patients’ perspective, it is uncontested that they retain their personal identity and that they consider themselves to be persons. We here include results from a survey with patients with LIS aimed at identifying the primary expectations of patients for their care by non-medical professionals. Based on these first-hand reports, we argue that personhood in LIS is progressively regained as the widening circle of others recognizes them as persons. (shrink)

When the richest 85 individuals in the world own as much as the poorest 3 billion people, one must ask about equity and social justice. Yet, the problem is not just individual, but also systemic. Just as nations have developed poverty lines to identify people who need help, so too, as this book argues, we need a measure of relative wealth that can guide policy makers, governments, development specialists, and economists. Approaching the question through theological, ethical, and economic analysis, the (...) book probes the dynamics of wealth creation, the effectiveness of national and international policies, and the underlying questions of poverty, wealth, and widening economic disparities. [Subject: Religious Studies, Ethics, Social Justice, Economic Policy]. (shrink)

Research on ethical formation in engineering has largely focused on assessing students’ abilities to recognize ethical issues and reason through ethical dilemmas. In this paper, we depict a conceptual framework for understanding how students develop into ethical engineers that involves dimensions beyond ethical awareness and judgment. In particular, we explore the role of ethical motivation in engineering students’ ethical formation. Ethical motivation is the process of deciding to act upon an ethical decision based on one’s valuing of ethics, as well (...) as one’s ability to prioritize moral concerns and professional values over personal interests. To prepare students to prioritize ethical and professional obligations, ethical training needs to help students become aware of and prepared to act upon both personal and professional values. This paper demonstrates how ethical motivation can be operationalized and assessed in engineering ethics curriculum by sharing findings from assessments implemented during an interdisciplinary engineering ethics course across two semesters. Findings from this study will provide insights into how students internalize professional values into their views of engineers’ roles and ultimately into their future practice as engineers. The approach used in this study can guide instructors interested in assessing ethical motivation and related constructs in their curriculums. (shrink)

Microbes can influence host physiology and behavior in many ways. Here we review evidence suggesting that some microbes can contribute to host stress (and other microbes can contribute to increased resilience to stress). We explain how certain microbes, which we call “stress microbes,” can potentially benefit evolutionarily from inducing stress in a host, gaining access to host resources that can help fuel rapid microbial replication by increasing glucose levels in the blood, increasing intestinal permeability, and suppressing the immune system. Other (...) microbes, which we term “resilience microbes,” can potentially benefit from making hosts more resilient to stress. We hypothesize that “stress microbes” use a fast life history strategy involving greater host exploitation while “resilience microbes” use a slow life history strategy characterized by more aligned evolutionary interests with the host. In this paper, we review the evidence that microbes affect host stress and explain the evolutionary pressures that could lead microbes to manipulate host stress, discuss the physiological mechanisms that are known to be involved in both stress and microbial activity, and provide some testable predictions that follow from this hypothesis. (shrink)

Purpose - The aim of this research was to investigate the effect of transformational leadership and transactional contingent reward as complementary, but distinct, forms of leadership on facets of organizational identification via the perception of innovation and goal organizational values. Design/methodology/approach – Three studies were carried out implementing either a measurement of mediation or experimental-causal-chain design to test for the hypothesized effects. Findings - The measurement of mediation study showed that transformational leadership had a positive direct and indirect effect, via (...) innovation value orientation, on cognitive identification, whereas transactional contingent reward was more strongly related to affective, rather than cognitive, identification, and goal orientation was a mediator of their link. The findings of the two experimental-causal-chain studies further supported the hypothesized effects. Transformational leadership was found to lead subordinates to perceive the culture as more innovative compared to transactional contingent reward, whereas transactional contingent reward led employees to perceive the culture as more goal, than innovation, oriented. Finally, innovation, compared to goal, value orientation increased cognitive identification, while goal orientation facilitated affective, rather than cognitive, identification. Implications - The practical implications involve the development of strategies organizations can apply, such as leadership training programs, to strengthen their ties with their employees, which, in turn, may have a positive impact on in-role, as well as extra-role, behaviors. Originality/Value – The originality of this research concerns the identification of distinct mechanisms explaining the effect of transformational leadership and transactional contingent reward on cognitive and affective identification applying an organizational culture perspective and a combination of measurement and causal mediation designs. (shrink)

Orienting biases for speech may provide a foundation for language development. Although human infants show a bias for listening to speech from birth, the relation of a speech bias to later language development has not been established. Here, we examine whether infants' attention to speech directly predicts expressive vocabulary. Infants listened to speech or non-speech in a preferential listening procedure. Results show that infants' attention to speech at 12 months significantly predicted expressive vocabulary at 18 months, while indices of general (...) development did not. No predictive relationships were found for infants' attention to non-speech, or overall attention to sounds, suggesting that the relationship between speech and expressive vocabulary was not a function of infants' general attentiveness. Potentially ancient evolutionary perceptual capacities such as biases for conspecific vocalizations may provide a foundation for proficiency in formal systems such language, much like the approximate number sense may provide a foundation for formal mathematics. (shrink)

Dispossession describes the condition of those who have lost land, citizenship, property, and a broader belonging to the world. This thought-provoking book seeks to elaborate our understanding of dispossession outside of the conventional logic of possession, a hallmark of capitalism, liberalism, and humanism. Can dispossession simultaneously characterize political responses and opposition to the disenfranchisement associated with unjust dispossession of land, economic and political power, and basic conditions for living? In the context of neoliberal expropriation of labor and livelihood, dispossession opens (...) up a performative condition of being both affected by injustice and prompted to act. From the uprisings in the Middle East and North Africa to the anti-neoliberal gatherings at Puerta del Sol, Syntagma and Zucchotti Park, an alternative political and affective economy of bodies in public is being formed. Bodies on the street are precarious - exposed to police force, they are also standing for, and opposing, their dispossession. These bodies insist upon their collective standing, organize themselves without and against hierarchy, and refuse to become disposable: they demand regard. This book interrogates the agonistic and open-ended corporeality and conviviality of the crowd as it assembles in cities to protest political and economic dispossession through a performative dispossession of the sovereign subject and its propriety. (shrink)

Pain, suffering and positive emotions in patients in vegetative state/unresponsive wakefulness syndrome (VS/uws) and minimally conscious states (MCS) pose clinical and ethical challenges. Clinically, we evaluate behavioural responses after painful stimulation and also emotionally-contingent behaviours (e.g., smiling). Using stimuli with emotional valence, neuroimaging and electrophysiology technologies can detect subclinical remnants of preserved capacities for pain which might influence decisions about treatment limitation. To date, no data exist as to how healthcare providers think about end-of-life options (e.g., withdrawal of artificial nutrition (...) and hydration) in the presence or absence of pain in non-communicative patients. Here, we aimed to better clarify this issue by re-analyzing previously published data on pain perception (Prog Brain Res 2009 177, 329–38) and end-of-life decisions (J Neurol 2010 258, 1058–65) in patients with disorders of consciousness. In a sample of 2259 European healthcare professionals we found that, for VS/uws more respondents agreed with treatment withdrawal when they considered that VS/uws patients did not feel pain (77%) as compared to those who thought VS/uws did feel pain (59%). This interaction was influenced by religiosity and professional background. For MCS, end-of-life attitudes were not influenced by opinions on pain perception. Within a contemporary ethical context we discuss (1) the evolving scientific understandings of pain perception and their relationship to existing clinical and ethical guidelines; (2) the discrepancies of attitudes within (and between) healthcare providers and their consequences for treatment approaches, and (3) the implicit but complex relationship between pain perception and attitudes toward life-sustaining treatments. (shrink)

Smartphone use changes the landscape of social interactions, including introducing new social dilemmas to daily life. The challenge of putting down one's smartphone is an example of a classic coordination problem from game theory: the stag hunt game. In a stag hunt game, there are two possible coordination points, one that involves big payoffs for both partners (e.g., working together to hunt large game like stag) and one that involves smaller payoffs for both partners (e.g., individually hunting small game like (...) rabbits) but is safer because it does not require that your partner choose that option as well. This is similar to the challenges of putting down smartphones to have a face‐to‐face interaction: you and your interaction partner might both prefer the higher payoff option of having a face‐to‐face interaction, but neither of you wants to put down your phone and risk not having anything to do in the meantime. It is also discussed how new technological innovations are changing the payoffs of face‐to‐face conversation versus side‐by‐side smartphone scrolling. Insights that come from applying game theory to this “social media dilemma” are discussed here and potential solutions that come out of a game theoretic analysis are offered. Also see the video abstract here https://youtu.be/9esL578zM‐E. (shrink)

This article applies a critical femininities perspective to the concept of women’s leadership, interrogating the market-oriented instrumentalization of femininity. The author presents empirical research consisting of in-depth interviews conducted with young women leaders in European student organizations. These participants juggle complicity and subversion as they negotiate the divergent expectations of femininity and leadership through interpersonal interactions and sociocultural positionalities. In these narratives the themes of social responsibility, difference, femininity, culture and embodiment are interlaced. The analysis of findings complicates monolithic interpretations (...) of femininity by evidencing intra-categorical fracturing, multiplicity in locations and manifestations of femininities, conflicting attachments and affective relations to femininity, and broader geopolitical contextualization. This theoretically and practically challenges tropes of hegemonic femininity, and presents opportunities for resistance. On this basis the author argues for countering the feminist trouble of engaging with non-transgressive femininity from within strongly normative spaces in the development of critical femininity studies. (shrink)

Drawing on a range of philosophical, anthropological and political theories, Athena Athanasiou offers a new way of thinking about agonistic performativity with its critical connections to national and gender politics and alongside the political intricacies of affectivity, courage and justice. Through an ethnographic account of the urban feminist and antinationalist movement Women in Black of Belgrade during the Yugoslav wars, she shows that we might understand their dissident politics of mourning as a means to refigure political life beyond sovereign (...) accounts of subjectivity and agency. (shrink)

Third Space, Hetero-Chronotopoi, Materialität – zwischenräumliche Strukturen als Analyseelemente machen raumzeitliche Merkmale vergangener und gegenwärtiger Gesellschaften und Untersuchungsgegenstände sichtbar. Der Band versammelt Beiträge verschiedener Disziplinen, deren Forschung von der Suche nach den jeweiligen Zwischenräumen wie ein roter Faden durchzogen ist. So wird ein Bogen gespannt von religiösen Zwischenräumen zu heterotopen Raum-Zeitlichkeiten als einer Spielart von Zwischenräumen bis hin zu zwischenräumlichen Materialitäten und Körperlichkeiten. Die Publikation zeichnet eine Entwicklung nach, die in den Erfurter Zwischenräume-Workshops mit je unterschiedlicher Schwerpunktsetzung zu „Zwischenräumen" begonnen (...) wurde und die sich im Aufgreifen und Anwenden etablierter und in der Entwicklung und dem Erproben neuer Analysekategorien auszeichnet. Die Ergebnisse der diskutierten Raumansätze sind innovativ und lassen jenseits bekannter Strukturen historische Zusammenhänge sichtbar werden. (shrink)

The reality of an ageing Europe has called attention to the importance of e-inclusion for a growing population of senior citizens. For some, this may mean closing the digital divide by providing access and support to technologies that increase citizen participation; for others, e-inclusion means access to assistive technologies to facilitate and extend their living independently. These initiatives address a social need and provide economic opportunities for European industry. While undoubtedly desirable, and supported by European Union initiatives, several cultural assumptions (...) or issues related to the initiatives could benefit from fuller examination, as could their practical and ethical implications. This paper begins to consider these theoretical and practical concerns. The first part of the paper examines cultural issues and assumptions relevant to adopting e-technologies, and the ethical principles applied to them. These include (1) the persistence of ageism, even in e-inclusion; (2) different approaches to, and implications of independent living; and (3) the values associated with different ethical principles, given their implications for accountability to older users. The paper then discusses practical issues and ethical concerns that have been raised by the use of smart home and monitoring technologies with older persons. Understanding these assumptions and their implications will allow for more informed choices in promoting ethical application of e-solutions for older persons. (shrink)

Pain, suffering and positive emotions in patients in vegetative state/unresponsive wakefulness syndrome (VS/UWS) and minimally conscious states (MCS) pose clinical and ethical challenges. Clinically, we evaluate behavioural responses after painful stimulation and also emotionally-contingent behaviours (e.g., smiling). Using stimuli with emotional valence, neuroimaging and electrophysiology technologies can detect subclinical remnants of preserved capacities for pain which might influence decisions about treatment limitation. To date, no data exist as to how healthcare providers think about end-of-life options (e.g., withdrawal of artificial nutrition (...) and hydration) in the presence or absence of pain in non-communicative patients. Here, we aimed to better clarify this issue by re-analyzing previously published data on pain perception (Prog Brain Res 2009 177, 329–38) and end-of-life decisions (J Neurol 2010 258, 1058–65) in patients with disorders of consciousness. In a sample of 2259 European healthcare professionals we found that, for VS/UWS more respondents agreed with treatment withdrawal when they considered that VS/UWS patients did not feel pain (77%) as compared to those who thought VS/UWS did feel pain (59%). This interaction was influenced by religiosity and professional background. For MCS, end-of-life attitudes were not influenced by opinions on pain perception. Within a contemporary ethical context we discuss (1) the evolving scientific understandings of pain perception and their relationship to existing clinical and ethical guidelines; (2) the discrepancies of attitudes within (and between) healthcare providers and their consequences for treatment approaches, and (3) the implicit but complex relationship between pain perception and attitudes toward life-sustaining treatments. (shrink)